Fluconazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

IV-$15/d PO-$3/d

Dosing

Adult

Loading dose for Candidemia
800mg IV

Serious Infections
(e.g. Candidemia, CNS/Endophthalmitis)
400-800mg IV daily

Other indications
100-400mg IV/PO daily

General Information

Common Usage

Candida infections both mucocutaneous and invasive - i.e. Candidemia.

Cryptococcus and Coccidioides infections.

Antifungal prophylaxis in immunocompromised.

Drug Monitoring

Consider QTc monitoring if concomitant drugs affecting the interval or elevated baseline measurement.

Adverse Effects

  • Drug interactions

  • QTc prolongation

  • Hepatic enzyme abnormalities

  • Rash

  • Alopecia

  • GI upset

Major Interactions

Many via CYP450 - suggest review specific patient medications.

Fluconazole increases levels of phenytoin, cyclosporine, tacrolimus, warfarin, oral hypoglycemics.

Risk when combining with other QTc prolonging medications.

Pharmacology

Antimicrobial class: Triazole antifungal, decreases ergosterol synthesis

Pregnancy category: C

Average serum half life: 20.0

Biliary penetration: Therapeutic

CSF penetration: Therapeutic

Lung penetration: Therapeutic

Urine penetration: Therapeutic